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Physical activity and cancer etiology: associations and mechanisms

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Abstract

Objectives: This paper reviews the epidemiologic data of associations between physical activity and cancer risk, describes potential mechanisms for a physical activity cancer link, and proposes future directions for research. Methods: We reviewed English-language published papers on physical activity and cancer through Medline searches for epidemiologic studies, and through references on individual reports. We reviewed general texts on effects of exercise on human biology and applied the concepts to the biology of cancer in humans to describe potential mechanisms for a physical activity–cancer association.

Results: Considerable epidemiologic evidence has accrued linking increased physical activity with reduced occurrence of cancers of the breast and colon. The association between physical activity and cancers of other sites is unclear. Potential mechanisms for the association between physical activity and reduced risk for breast and colon cancer are varied: they range from bias due to physical activity's strong correlations with other health factors (e.g., diet, smoking, alcohol use, use of medications) to the metabolic effects resulting from increased physical activity and fitness, such as reduced obesity, hormonal and reproductive effects, mechanical effects, and enhancement of the immune system.

Conclusions: The elucidation of biologic mechanisms for an association between physical activity and cancer may provide biological support for the association. It will contribute information to determine the type, frequency, and duration of exercise needed to maximize protection. This information will be needed before large-scale community interventions are begun, in order to choose the correct interventions for the desired effect of reduced incidence of the most common cancers.

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References

  1. U.S. Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services Center for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion; 1996: 87–102.

    Google Scholar 

  2. Manson J, Rimm E, Stampfer M, et al. Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 1991; 338: 774–8.

    Article  PubMed  Google Scholar 

  3. Lynch J, Helmrich S, TA L. Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men. Arch Intern Med 1996; 156: 1307–14.

    Article  PubMed  Google Scholar 

  4. Elward K, Larson EB. Benefits of exercise for older adults. A review of existing evidence and current recommendations for the general population. Clin Geriatr Med 1992; 8: 35–50.

    PubMed  Google Scholar 

  5. Blair SN. Evidence for success of exercise in weight loss and control. Ann Intern Med 1993; 119: 702–6.

    PubMed  Google Scholar 

  6. Swoap R, Novell N, Graves J, Pollock M. High versus moderate intensity aerobic exercise in older adults: psychological and physiological effects. Journal of Aging and Physical Activity 1994; 2: 293–303.

    Google Scholar 

  7. Rook A. An investigation into the longevity of Cambridge sportsmen. Br Med J 1954; 1: 773–7.

    Google Scholar 

  8. Taylor H, Klepetar E, Keys A, et al. Death rates among physically active employees of the railroad industry. Am J Public Health 1962; 52: 1697–1707.

    PubMed  Google Scholar 

  9. Shephard RJ. Physical activity and cancer. International Journal of Sports Medicine 1990; 11: 413–20.

    PubMed  Google Scholar 

  10. Berg JW, Howell MA. Occupation and bowel cancer. J Toxicol Environ Health 1975; 1: 75–89.

    PubMed  Google Scholar 

  11. Vena JE, Graham S, Zielezny M, Swanson MK, Barnes RE, Nolan J. Lifetime occupational exercise and colon cancer. Am J Epidemiol 1985; 122: 357–65.

    PubMed  Google Scholar 

  12. Garabrant DH, Peters JM, Mack TM, Bernstein L. Job activity and colon cancer risk. Am J Epidemiol 1984; 119: 1005–14.

    PubMed  Google Scholar 

  13. Frisch RE, Wyshak G, Albright NL, et al. Lower prevalence of breast cancer and cancers of the reproductive system among former college athletes compared to non-athletes. Br J Cancer 1985; 52: 885–91.

    PubMed  Google Scholar 

  14. Bernstein L, Henderson BE, Hanisch R, Sullivan-Halley J, Ross RK. Physical exercise and reduced risk of breast cancer in young women [see comments]. J Natl Cancer Inst 1994; 86: 1403–8.

    PubMed  Google Scholar 

  15. Dorgan JF, Brown C, Barrett M, et al. Physical activity and risk of breast cancer in the Framingham Heart Study. Am J Epidemiol 1994; 139: 662–9.

    PubMed  Google Scholar 

  16. DAvanzo B, Nanni O, LaVecchia C, et al. Physical activity and breast cancer risk. Cancer Epidemiol Biomarkers Prev 1996; 5: 155–60.

    PubMed  Google Scholar 

  17. Mittendorf R, Longnecker MP, Newcomb PA, et al. Strenuous physical activity in young adulthood and risk of breast cancer (United States). Cancer Causes Control 1995; 6: 347–53.

    PubMed  Google Scholar 

  18. McTiernan A, Stanford JL, Weiss NS, Daling JR, Voigt LF. Occurrence of breast cancer in relation to recreational exercise in women age 50–64 years. Epidemiology 1996; 7: 598–604.

    PubMed  Google Scholar 

  19. Thune I, Brenn T, Lund E, Gaard M. Physical activity and the risk of breast cancer [see comments]. N Engl J Med 1997; 336: 1269–75.

    Article  PubMed  Google Scholar 

  20. Jacobs DR, Jr., Ainsworth BE, Hartman TJ, Leon AS. A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 1993; 25: 81–91.

    PubMed  Google Scholar 

  21. Ainsworth BE, Richardson M, Jacobs DRJ, Leon A. Gender differences in physical activity. Women in Sport and Physical Activity Journal 1993; 2: 1–15.

    Google Scholar 

  22. Blair SN, Haskell WL, Ho P, et al. Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. Am J Epidemiol 1985; 122: 794–804.

    PubMed  Google Scholar 

  23. Albanes D, Blair A, Taylor PR. Physical activity and risk of cancer in the NHANES I population. Am J Public Health 1989; 79: 744–50.

    PubMed  Google Scholar 

  24. MinnesotaLeisure Time Physical Activity Questionnaire Manual. NM 55455: Division of Epidmiology, School of Public Health, University of Minnesota.

  25. Wolf AM, Hunter DJ, Colditz GA, et al. Reproducibility and validity of a self-administered physical activity questionnaire. Int J Epidemiol 1994; 23: 991–9.

    PubMed  Google Scholar 

  26. Durstine JL, King AC, Painter PL, et al. American College Sports Medicine Resource Manual for Guidelines for Exercise Testing and Prescription. 2nd ed. Philadelphia, PA: Lea & Febiger; 1993.

    Google Scholar 

  27. Kampert JB, Blair SN, Barlow CE, Kohl HW, 3rd. Physical activity, physical fitness, and all-cause and cancer mortality: a prospective study of men and women. Ann Epidemiol 1996; 6: 452–7.

    Article  PubMed  Google Scholar 

  28. Gerhardsson M, Norell SE, Kiviranta H, Pedersen NL, Ahlbom A. Sedentary jobs and colon cancer. Am J Epidemiol 1986; 123: 775–80.

    PubMed  Google Scholar 

  29. Paffenbarger RS, Jr., Hyde RT, Wing AL. Physical activity and incidence of cancer in diverse populations: a preliminary report. Am J Clin Nutr 1987; 45: 312–7.

    PubMed  Google Scholar 

  30. Lee IM, Paffenbarger RS, Hsieh CC. Physical activity and risk of developing colorectal cancer among college alumni. J Natl Cancer Inst 1991; 83: 1324–9.

    PubMed  Google Scholar 

  31. Giovannucci E, Ascherio A, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Physical activity, obesity, and risk for colon cancer and adenoma in men. Ann Int Med 1995; 122: 327–34.

    PubMed  Google Scholar 

  32. Ballard-Barbash R, Schatzkin A, Albanes D, et al. Physical activity and risk of large bowel cancer in the Framingham Study. Cancer Research 1990; 50: 3610–3.

    PubMed  Google Scholar 

  33. Severson RK, Nomura AM, Grove JS, Stemmermann GN. A prospective analysis of physical activity and cancer. Am J Epidemiol 1989; 130: 522–9.

    PubMed  Google Scholar 

  34. Wu AH, Paganini-Hill A, Ross RK, Henderson BE. Alcohol, physical activity and other risk factors for colorectal cancer: a prospective study. Br J Cancer 1987; 55: 687–94.

    PubMed  Google Scholar 

  35. Martinez ME, Giovannucci E, Speigelman D, et al. Leisure-time, physical activity, body size, and colon cancer in women. J Natl Cancer Inst 1997; 89: 948–55.

    PubMed  Google Scholar 

  36. Thune I, Lund E. Physical activity and risk of colorectal cancer in men and women. Br J Cancer 1996; 73: 1134–40.

    PubMed  Google Scholar 

  37. Lee IM, Manson JE, Ajani U, et al. Physical activity and risk of colon cancer: The Physicians' Health Survey (United States). Cancer Causes Control 1997; 8: 568–74.

    Article  PubMed  Google Scholar 

  38. Brownson RC, Chang JC, Davis JR, Smith CA. Physical activity on the job and cancer in Missouri. Am J Public Health 1991; 81: 639–42.

    PubMed  Google Scholar 

  39. Marcus PM, Newcomb PA, Storer BE. Early adulthood physical activity and colon cancer risk among Wisconsin women. Cancer Epidemiol, Biomarkers Prev 1994; 3: 641–4.

    Google Scholar 

  40. Fredriksson M, Bengtsson NO, Hardell L, Axelson O. Colon cancer, physical activity, and occupational exposures. A case-control study. Cancer 1989; 63: 1838–42.

    PubMed  Google Scholar 

  41. Kato I, Tominaga S, Ikari A. A case-control study of male colorectal cancer in Aichi Prefecture, Japan: with special reference to occupational activity level, drinking habits and family history. Jpn J Cancer Res 1990; 81: 115–21.

    PubMed  Google Scholar 

  42. Kune GA, Kune S, Watson LF. Body weight and physical activity as predictors of colorectal cancer risk. Nutr Cancer 1990; 13: 9–17.

    PubMed  Google Scholar 

  43. Whittemore A, Wu-Williams AJ, Lee M, et al. Diet, physical activity and colorectal cancer among Chinese in North America and China. J Natl Cancer Inst 1990; 82: 915–26.

    PubMed  Google Scholar 

  44. Slattery ML, Schumacher MC, Smith KR, West DW, Abd-Elghany N. Physical activity, diet, and risk of colon cancer in Utah [see comments]. Am J Epidemiol 1988; 128: 989–99.

    PubMed  Google Scholar 

  45. Slattery ML, Abd-Elghany N, Kerber R, Schumacher MC. Physical activity and colon cancer: a comparison of various indicators of physical activity to evaluate the association. Epidemiology 1990; 1: 481–5.

    PubMed  Google Scholar 

  46. Gerhardssonde Verdier M, Steineck G, Hagman U, Rieger A, Norell SE. Physical activity and colon cancer: a case-referent study in Stockholm. Int J Cancer 1990; 46: 985–9.

    PubMed  Google Scholar 

  47. Dosemici M, Hayes R, Vetter R, et al. Occupational physical activity, socioeconomic status, and risks of 15 cancer sites in Turkey. Cancer Causes Control 1993; 4: 313–21.

    PubMed  Google Scholar 

  48. Fraser G, Pearce N. Occupational physical activity and risk of cancer of the colon and rectum in New Zealand males. Cancer Causes Control 1993; 4: 45–50.

    PubMed  Google Scholar 

  49. Slattery ML, Edwards SL, Ma KN, Friedman GD, Potter JD. Physical activity and colon cancer: a public health perspective. Ann Epidemiol 1997; 7: 137–45.

    Article  PubMed  Google Scholar 

  50. White E, Jacobs EJ, Daling JR. Physical activity in relation to colon cancer in middle-aged men and women. Am J Epidemiol 1996; 144: 42–50.

    PubMed  Google Scholar 

  51. Longnecker MP, Gerhardssonle Verdier M, Frumkin H, Carpenter C. A case-control study of physical activity in relation to risk of cancer of the right colon and rectum in men. Int J Epidemiol 1995; 24: 42–50.

    PubMed  Google Scholar 

  52. Giovannucci E, Colditz G, Stampfer M, Willett W. Physical activity, obesity, and risk of colorectal adenoma in women (United States). Cancer Causes Control 1995; 7: 253–63.

    Google Scholar 

  53. Kono S, Shinchi K, Ikeda N, Yanai F, Imanishi K. Physical activity, dietary habits and adenomatous polyps of the sigmoid colon: a study of self-defense officials in Japan [see comments]. J Clin Epidemiol 1991; 44: 1255–61.

    Article  PubMed  Google Scholar 

  54. Colditz GA, Cannuscio CC, Frazier AL. Physical activity and reduced risk of colon cancer: implications for prevention. Cancer Causes Control 1997; 8: 649–67.

    Article  PubMed  Google Scholar 

  55. Gammon MD, John EM, Britton JA. Recreational and occupational physical activities and risk of breast cancer. J Natl Cancer Inst 1998; 90: 100–17.

    Article  PubMed  Google Scholar 

  56. Pukkala E, Poskiparta M, Apter D, Vihko V. Life-long physical activity and cancer risk among Finnish female teachers. Eur J Cancer Prev 1993; 2: 369–76.

    PubMed  Google Scholar 

  57. Cerhan J, Chiu B, Wallace R, et al. Systolic blood pressure, physical activity, and risk of breast cancer in elderly women (abstract). Am J Epidemiol 1996; 143: S71.

    Google Scholar 

  58. Zheng W, Shu XO, McLaughlin JK, Chow WH, Gao YT, Blot WJ. Occupational physical activity and the incidence of cancer of the breast, corpus uteri, and ovary in Shanghai. Cancer 1993; 71: 3620–4.

    PubMed  Google Scholar 

  59. Gammon MD, Schoenberg JB, Britton JA, et al. Recreational physical activity and breast cancer risk among women under age 45 years. Am J Epidemiol 1998; 147: 273–80.

    PubMed  Google Scholar 

  60. Hirose K, Tajima K, Hamajima N, et al. A large-scale, hospital-based case-control study of risk factors of breast cancer according to menopausal status. Jpn J Cancer Res 1995; 86: 146–54.

    PubMed  Google Scholar 

  61. Chen CL, White E, Malone KE, Daling JR. Leisure-time physical activity in relation to breast cancer among young women (Washington, United States). Cancer Causes Control 1997; 8: 77–84.

    Article  PubMed  Google Scholar 

  62. Sternfeld D, William C, Quesenberry C, et al. Lifetime physical activity and incidence of breast cancer. Med Sci Sports Exerc 1993; 25: S147.

    Google Scholar 

  63. Hu YH, Nagata C, Shimizu H, Kaneda N, Kashiki Y. Association of body mass index, physical activity, and reproductive histories with breast cancer: a case-control study in Gifu, Japan. Breast Cancer Res Treat 1997; 43: 65–72.

    Article  PubMed  Google Scholar 

  64. Coogan PF, Newcomb PA, Clapp RW, Trentham-Dietz A, Baron JA, Longnecker MP. Physical activity in usual occupation and risk of breast cancer (United States). Cancer Causes Control 1997; 8: 626–31.

    Article  PubMed  Google Scholar 

  65. Friedenreich CM, Rohan TE. Physical activity and risk of breast cancer. Eur J Cancer Prev 1995; 4: 145–51.

    PubMed  Google Scholar 

  66. Carpenter CL, Ross R, Paginini-Hill A, Bernstein L. Lifetime physical activity and breast cancer risk among postmenopausal women (abstract). Am J Epidemiol 1996; 143: S87.

    Google Scholar 

  67. Gram I, Funkhouser E, Tabar L. Physical activity in relation to mammographic patterns. Am J Epidemiol 1996; 143: S71.

    Google Scholar 

  68. Wyshak G, Frisch RE, Albright NL, Albright TE, Schiff I. Lower prevalence of benign diseases of the breast and benign tumours of the reproductive system among former college athletes compared to non-athletes. Br J Cancer 1986; 54: 841–5.

    PubMed  Google Scholar 

  69. Shu XO, Hatch MC, Zheng W, Gao YT, Brinton LA. Physical activity and risk of endometrial cancer. Epidemiology 1993; 4: 342–9.

    PubMed  Google Scholar 

  70. Levi F, LaVecchia C, Negri E, Franceschi S. Selected physical activities and the risk of endometrial cancer. Br J Cancer 1993; 67: 846–51.

    PubMed  Google Scholar 

  71. Sturgeon SR, Brinton LA, Berman ML, et al. Past and present physical activity and endometrial cancer risk. Br J Cancer 1993; 68: 584–9.

    PubMed  Google Scholar 

  72. Mink PJ, Folsom AR, Sellers TA, Kushi LH. Physical activity, waist-to-hip ratio, and other risk factors for ovarian cancer: a follow-up study of older women. Epidemiology 1996; 7: 38–45.

    PubMed  Google Scholar 

  73. Gallagher RP, Huchcroft S, Phillips N, et al. Physical activity, medical history, and risk of testicular cancer (Alberta and British Columbia, Canada). Cancer Causes Control 1995; 6: 398–406.

    PubMed  Google Scholar 

  74. United Kingdom Testicular Cancer Study Group. Aetiology of testicular cancer: association with congenital abnormalities, age at puberty, infertility, and exercise. Br Med J 1994; 308: 1393–8.

    Google Scholar 

  75. Thune I, Lund E. Physical activity and the risk of prostate and testicular cancer: a cohort study of 53,000 Norwegian men. Cancer Causes Control 1994; 5: 549–56.

    PubMed  Google Scholar 

  76. Coldman A, Eldwood J, Gallagher R. Sports activities and risk of testicular cancer. Br J Cancer 1982; 46: 169–79.

    Google Scholar 

  77. Paffenbarger RS, Jr., Lee IM, Wing AL. The influence of physical activity on the incidence of site-specific cancers in college alumni. Adv Exp Med Biol 1992; 322: 7–15.

    PubMed  Google Scholar 

  78. Hartman TJ, Albanes D, Rautalahti M, et al. Physical activity and prostate cancer in the Alpha-Tocopherol, Beta-Carotene (ATBC) Cancer Prevention Study (Finland). Cancer Causes Control 1998; 9: 11–8.

    Article  PubMed  Google Scholar 

  79. Oliveria SA, Kohl HW, III, Trichopoulos D, Blair SN. The association between cardiorespiratory fitness and prostate cancer. Med Sci Sports Exerc 1996; 28: 97–104.

    Article  PubMed  Google Scholar 

  80. Steenland K, Nowlin S, Palu S. Cancer incidence in the National Health and Nutrition Survey I. Follow-up data: diabetes, cholesterol, pulse and physical activity. Cancer Epidemiol Biomarkers Prev 1995; 4: 807–11.

    PubMed  Google Scholar 

  81. Lee IM, Paffenbarger RS, Jr., Hsieh CC. Physical activity and risk of prostatic cancer among college alumni. Am J Epidemiol 1992; 135: 169–79.

    PubMed  Google Scholar 

  82. Cerhan JR, Torner JC, Lynch CF, et al. Association of smoking, body mass, and physical activity with risk of prostate cancer in the Iowa 65+ Rural Health Study (United States). Cancer Causes Control 1997; 8: 229–38.

    Article  PubMed  Google Scholar 

  83. West D, Slattery M, Robison L, et al. Adult dietary intake and prostate cancer in Utah: a case-control study with special emphasis on aggressive tumors. Cancer Causes Control 1991; 2: 85–94.

    PubMed  Google Scholar 

  84. Ilic M, Vlajinac H, Marinkovic J. Case-control study of risk factors for prostate cancer. Br J Cancer 1996; 74: 1682–6.

    PubMed  Google Scholar 

  85. Huang Z, Hankinson SE, Colditz GA, et al. Dual effects of weight and weight gain on breast cancer risk. JAMA 1997; 278: 1407–11.

    PubMed  Google Scholar 

  86. Hsing AW, McLaughlin JK, Zheng W, Gao YT, Blot WJ. Occupation, physical activity, and risk of prostate cancer in Shanghai, People's Republic of China. Cancer Causes Control 1994; 5: 136–40.

    PubMed  Google Scholar 

  87. Andersson SO, Baron J, Wolk A, Lindgren C, Bergstrom R, Adami HO. Early life risk factors for prostate cancer: a population-based case-control study in Sweden. Cancer Epidemiol Biomarkers Prev 1995; 4: 187–92.

    PubMed  Google Scholar 

  88. Whittemore AS, Kolonel LN, Wu AH, et al. Prostate cancer in relation to diet, physical activity, and body size in blacks, whites, and Asians in the United States and Canada [see comments]. J Natl Cancer Inst 1995; 87: 652–61.

    PubMed  Google Scholar 

  89. Yu H, Harris RE, Wynder EL. Case-control study of prostate cancer and socioeconomic factors. Prostate 1988; 13: 317–25.

    PubMed  Google Scholar 

  90. Polednak AP. College athletics, body size, and cancer mortality. Cancer 1976; 38: 382–7.

    PubMed  Google Scholar 

  91. Le Marchand L, Koldand LN, Yoshizaiva CN. Lifetime physical activity and prostate cancer risk. Am J Epidemiol 1991; 133: 103–11.

    PubMed  Google Scholar 

  92. Vena JE, Graham S, Zielezny M, Brasure J, Swanson MK. Occupational exercise and risk of cancer. Am J Clin Nutr 1987; 45: 318–27.

    PubMed  Google Scholar 

  93. Thune I, Lund E. The influence of physical activity on lung-cancer risk: A prospective study of 81,516 men and women. Int J Cancer 1997; 70: 57–62.

    PubMed  Google Scholar 

  94. Frisch RE, Wyshak G, Albright NL, Albright TE, Schiff I. Lower prevalence of non-reproductive system cancers among female former college athletes. Med Sci Sports Exerc 1989; 21: 250–3.

    PubMed  Google Scholar 

  95. Wannamethee G, Shaper AG, Macfarlane PW. Heart rate, physical activity, and mortality from cancer and other noncardiovascular diseases. Am J Epidemiol 1993; 137: 735–48.

    PubMed  Google Scholar 

  96. Enstrom J. Health practices and cancer mortality among active California Mormons. J Natl Cancer Inst 1989; 81: 1807–14.

    PubMed  Google Scholar 

  97. Persky V, Dyer AR, Leonas J, et al. Heart rate: a risk factor for cancer? Am J Epidemiol 1981; 114: 477–87.

    PubMed  Google Scholar 

  98. Leon AS, Connett J. Physical activity and 10.5 year mortality in the Multiple Risk Factor Intervention Trial (MRFIT). Int J Epidemiol 1991; 20: 690–7.

    PubMed  Google Scholar 

  99. Yusuf HR, Croft JB, Giles WH, et al. Leisure-time physical activity among older adults. United States, 1990. Arch Int Med 1996; 156: 1321–6.

    Article  Google Scholar 

  100. McTiernan A, Stanford J, Daling J, Voigt L. Prevalence and correlates of recreational physical activity in women aged 50-64 years. Menopause 1998; 5: 95–101

    PubMed  Google Scholar 

  101. Parkin D, Pisani P, Lopez A, Masuyer E. At least one in seven cases of cancer is caused by smoking. Global estimates for 1985. Int J Cancer 1994; 59: 494–504.

    PubMed  Google Scholar 

  102. McTiernan A. Exercise and breast cancer—time to get moving? [editorial; comment] [see comments]. N Engl J Med 1997; 336: 1311–2.

    Article  PubMed  Google Scholar 

  103. Oliveria SA, Lee IM. Is exercise beneficial in the prevention of prostate cancer? Sports Med 1997; 23: 271–8.

    PubMed  Google Scholar 

  104. Beresford SA, Weiss NS, Voigt LF, McKnight B. Risk of endometrial cancer in relation to use of oestrogen combined with cyclic progestagen therapy in postmenopausal women. Lancet 1997; 349: 458–61.

    Article  PubMed  Google Scholar 

  105. Anonymous. Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Collaborative Group on Hormonal Factors in Breast Cancer [see comments]. Lancet 1996; 347: 1713–27.

  106. Grodstein F, Martinez ME, Platz EA, et al. Postmenopausal hormone use and risk for colorectal cancer and adenoma [see comments]. Ann Int Med 1998; 128: 705–12.

    PubMed  Google Scholar 

  107. Rosenberg L, Palmer J, Zauber A, et al. A hypothesis: nonsteroidal anti-inflammatory drugs reduce the incidence of large-bowel cancer. J Natl Cancer Inst 1991; 83: 355–8.

    PubMed  Google Scholar 

  108. Potter JD, Slattery ML, Bostick RM, Gapstur SM. Colon cancer: a review of the epidemiology. Epidemiol Rev 1993; 15: 499–545.

    PubMed  Google Scholar 

  109. Matthews KA, Kuller LH, Wing RR, Meilahn EN, Plantinga P. Prior to use of estrogen replacement therapy, are users healthier than nonusers? [see comments]. Am J Epidemiol 1996; 143: 971–8.

    PubMed  Google Scholar 

  110. Patterson RE, Neuhouser ML, White E, Hunt JR, Kristal AR. Cancer-related behavior of vitamin supplement users. Cancer Epidemiol Biomarkers Prev 1998; 7: 79–81.

    PubMed  Google Scholar 

  111. Schwartz R, Buchner D. Exercise in the elderly: physiologic and functional effects. In: Hazzard W, ed. Principles of Geriatric Medicine. New York: McGraw-Hill, 1998.

    Google Scholar 

  112. Rosenberg L, Metzger LS, Palmer JR. Alcohol consumption and risk of breast cancer: a review of the epidemiologic evidence. Epidemiol Rev 1993; 15: 133–44.

    PubMed  Google Scholar 

  113. Potter J, McMichael A, Hatshorne J. Alcohol and beer consumption in relation to cancers of bowel and lung: an extended correlation analysis. J Chronic Dis 1982; 35: 833–42.

    Article  PubMed  Google Scholar 

  114. Patterson R, Haines P, Popkin B. Health lifestyle patterns of U.S. adults. Preventive Medicine 1994; 23: 453–60.

    Article  PubMed  Google Scholar 

  115. Ginsburg ES, Mello NK, Mendelson JH, et al. Effects of alcohol ingestion on estrogens in postmenopausal women. JAMA. 1996; 276: 1747–51.

    PubMed  Google Scholar 

  116. Simoes EJ, Byers T, Coates RJ, Serdula MK, Mokdad AH, Heath GW. The association between leisure-time physical activity and dietary fat in American adults [see comments]. Am J Public Health 1995; 85: 240–4.

    PubMed  Google Scholar 

  117. Shephard RJ, Shek PN. Cancer, immune function, and physical activity. Can J Appl Physiol 1995; 20: 1–25.

    PubMed  Google Scholar 

  118. Prentice RL, Sheppard L. Dietary fat and cancer: consistency of the epidemiologic data, and disease prevention that may follow from a practical reduction in fat consumption [published erratum appears in Cancer Causes Control 1990 Nov; 1(3): 253]. Cancer Causes Control 1990; 1: 81–97; discussion 99-109.

    PubMed  Google Scholar 

  119. Yang Q, Khoury MJ. Evolving methods in genetic epidemiology. III. Gene-environment interaction in epidemiologic research. Epidemiol Rev 1997; 19: 33–43.

    PubMed  Google Scholar 

  120. Bouchard C. Discussion: Heredity, fitness, and health. In: Bouchard C, Shepard RJ, Stephens T, et al. eds. Exercise, Fitness, and Health. Champaigne, IL: Human Kinetics; 1990: 147.

    Google Scholar 

  121. Sellers TA, Gapstur SM, Potter JD, Kushi LH, Bostick RM, Folsom AR. Association of body fat distribution and family histories of breast and ovarian cancer with risk of postmenopausal breast cancer. Am J Epidemiol 1993; 138: 799–803.

    PubMed  Google Scholar 

  122. McKeown-Eyssen G. Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk? Cancer Epidemiol Biomarkers Prev 1994; 3: 687–95.

    PubMed  Google Scholar 

  123. Holman C, Armstrong B. Cutaneous malignant melanoma and indicators of total accumulated exposure to the sun: an analysis separating histogenetic types. J Natl Cancer Inst 1986; 73: 75–82.

    Google Scholar 

  124. Kohlmeier L, Kohlmeier M. Adipose tissue as a medium for epidemiologic exposure assessment. Environ Health Perspect 1995; 103: 99–106.

    Google Scholar 

  125. Comstock G, Bush T, Helzlsouer K, et al. Serum retinol, beta carotene, vitamin A, and selenium as related to subsequent cancer of specific sites. Am J Epidemiol 1992; 135: 115–21.

    PubMed  Google Scholar 

  126. Swanson CA, Pitischman N, Wilbanks GD, et al. Risk of endometrial cancer in relation to contemporary and past body size. Cancer Epidemiol Biomarkers Prev 1993; 2: 321–7.

    PubMed  Google Scholar 

  127. King AC, Tribble DL. The role of exercise in weight regulation in nonathletes. Sports Med 1991; 11: 331–49.

    PubMed  Google Scholar 

  128. Krotkiewski M, Bjorntorp P, Sjostrom L, Smith U. Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution. J Clin Invest 1983; 72: 1150–62.

    PubMed  Google Scholar 

  129. Schwartz RS, Shuman WP, Bradbury VL, et al. The effect of intensive endurance training on body fat distribution in young and older men. Metabolism 1991; 40.

  130. Wood PD. Impact of experimental manipulation of energy intake and expenditure on body composition. Crit Rev Food Sci Nutr 1993; 33: 369–73.

    PubMed  Google Scholar 

  131. Yee D, Paik S, Lebovic GS, et al. Analysis of insulin-like growth factor I gene expression in malignancy: evidence for a paracrine role in human breast cancer. Mol Endocrinol 1989; 3: 509–17.

    PubMed  Google Scholar 

  132. Schwartz RS. Exercise training in the treatment of diabetes mellitus in elderly patients. Diabetes Care 1990; 14: 77.

    Google Scholar 

  133. Chan JM, Stampfer MJ, Giovannucci E, et al. Plasma insulin-like growth factor-I and prostate cancer risk: a prospective study [see comments]. Science 1998; 279: 563–6.

    Article  PubMed  Google Scholar 

  134. Hankinson S, Willett W, Colditz G, et al. Circulating concentrations of insulin-like growth factor-I and risk of breast cancer. Lancet 1998; 351: 1393–96.

    Article  PubMed  Google Scholar 

  135. McCarty MF. Up-regulation of IGF binding protein-1 as an anticarcinogenic strategy: relevance to caloric restriction, exercise, and insulin sensitivity. Med Hypotheses 1997; 48: 297–308.

    PubMed  Google Scholar 

  136. Ross J, Potter J, Severson R. Platelet-derived growth factor and risk factors for colorectal cancer. Eur J Cancer Prev 1993; 2: 197–210.

    PubMed  Google Scholar 

  137. Aaronson S. Growth factors and cancer. Science 1991; 254: 1146–53.

    PubMed  Google Scholar 

  138. Rauramaa R, Salonen J, Seppanen K, et al. Inhibition of platelet aggregability by moderate-intensity physical exercise: a randomized clinical trial in overweight men. Circulation 1986; 74: 939–44.

    PubMed  Google Scholar 

  139. Sinzinger H, Virgolini I. Effects of exercise on parameters of blood coagulation, platelet function and the prostaglandin system. Sports Med 1988; 6: 238–45.

    PubMed  Google Scholar 

  140. Davis R, Boyd D, McKinney M, Jones C. Effects of exercise and exercise conditioning on blood platelet function. Med Sci Sports Exerc 1990; 22: 49–53.

    PubMed  Google Scholar 

  141. McMahon L, Ryan M, Larson D, et al. Occult gastrointestinal blood loss in marathon runners. Ann Int Med 1984; 100: 846–50.

    PubMed  Google Scholar 

  142. Lauffer R. Exercise as prevention: do the health benefits derive in part from lower iron levels? Med Hypothesis 1991; 35: 103–7.

    Article  Google Scholar 

  143. Calabrese LH. Exercise, immunity, cancer and infection. In: Bouchard C, Shephard RH, Stephens T, Sutton J, McPherson B, eds. Exercise, Fitness, and Health: A Consensus of Current Knowledge. Champaigne, IL: Human Kinetics; 1990: 567–579.

    Google Scholar 

  144. Nieman DC. Exercise, upper respiratory tract infection, and the immune system. Med Sci Sports Exerc 1994; 26: 128–39.

    PubMed  Google Scholar 

  145. Shephard RJ, Rhind S, Shek PN. The impact of exercise on the immune system: NK cells, interleukins 1 and 2, and related responses. Exerc Sport Sci Rev 1995; 23: 215–41.

    PubMed  Google Scholar 

  146. Karre K, Klein GO, Kiessling R, Klein G, Roder JC. In vitro NK-activity and in vivo resistance to leukemia: studies of beige, beige//nude and wild-type hosts on C57BL background. Int J Cancer 1980; 26: 789–97.

    PubMed  Google Scholar 

  147. Lala PK, Santer V, Libenson H, Parhar RS. Changes in the host natural killer cell population in mice during tumor development. 1. Kinetics and in vivo significance. Cell Immunol 1985; 93: 250–64.

    PubMed  Google Scholar 

  148. Nagel JE, Chopra RK, Powers DC, Adler WH. Effect of age on the human high affinity interleukin 2 receptor of phytohaemagglutinin stimulated peripheral blood lymphocytes. Clin Exp Immunol 1989; 75: 286–91.

    PubMed  Google Scholar 

  149. Hessen MT, Kaye D, Murasko DM. Heterogeneous effects of exogenous lymphokines on lymphoproliferation of elderly subjects. Mech Ageing Dev 1991; 58: 61–73.

    Article  PubMed  Google Scholar 

  150. Nieman DC, Nehlsen-Cannarella SL, Markoff PA, et al. The effects of moderate exercise training on natural killer cells and upper respiratory tract infections. Int J Sports Med 1990; 11: 467–74.

    PubMed  Google Scholar 

  151. Nieman DC, Henson DA, Gusewitch G, et al. Physical activity and immune function in elderly women. Med Sci Sports Exerc 1993; 25: 823–31.

    PubMed  Google Scholar 

  152. Paavonen T. Hormonal regulation of immune responses. Ann Med 1994; 26: 255–8.

    PubMed  Google Scholar 

  153. Lahita RG. The effects of sex hormones on the immune system in pregnancy. Am J Reprod Immunol 1992; 28: 136–7.

    PubMed  Google Scholar 

  154. Cutolo M, Sulli A, Seriolo B, Accardo S, Masi AT. Estrogens, the immune response and autoimmunity. Clin Exp Rheumatol 1995; 13: 217–26.

    PubMed  Google Scholar 

  155. Van Vollenhofen RF, McGuire JL. Estrogen, progesterone, and testosterone: can they be used to treat autoimmune diseases? Cleve Clin J Med 1994; 61: 276–84.

    PubMed  Google Scholar 

  156. Studzinski G, Moore D. Sunlight—can it prevent as well as cause cancer? Cancer Res 1995; 55: 4014–22.

    PubMed  Google Scholar 

  157. Braun MM, Helzlsouer KJ, Hollis BW, Comstock GW. Colon cancer and serum vitamin D metabolite levels 10–17 years prior to diagnosis. Am J Epidemiol 1995; 142: 608–11.

    PubMed  Google Scholar 

  158. Gann PH, Ma J, Hennekens CH, Hollis BW, Haddad JG, Stampfer MJ. Circulating vitamin D metabolites in relation to subsequent development of prostate cancer. Cancer Epidemiol Biomarkers Prev 1996; 5: 121–6.

    PubMed  Google Scholar 

  159. Hiatt RA, Krieger N, Lobaugh B, Drezner MK, Vogelman JH, Orentreich N. Prediagnostic serum vitamin D and breast cancer. J Natl Cancer Inst 1998; 90: 461–3.

    Article  PubMed  Google Scholar 

  160. Kearney J, Giovannucci E, Rimm EB, et al. Calcium, vitamin D, and dairy foods and the occurrence of colon cancer in men. Am J Epidemiol 1996; 143: 907–17.

    PubMed  Google Scholar 

  161. La Vecchia C, Braga C, Negri E, et al. Intake of selected micronutrients and risk of colorectal cancer. Int J Cancer 1997; 73: 525–30.

    Article  PubMed  Google Scholar 

  162. Martinez ME, Giovannucci EL, Colditz GA, et al. Calcium, vitamin D, and the occurrence of colorectal cancer among women. J Natl Cancer Inst 1996; 88: 1375–82.

    PubMed  Google Scholar 

  163. Nelson ME, Meredith CN, Dawson-Hughes B, Evans WJ. Hormone and bone mineral status in endurance-trained and sedentary postmenopausal women. J Clin Endocrinol Metab 1988; 66: 927–33.

    PubMed  Google Scholar 

  164. Pritchard RS, Baron JA, Gerhardssonde Verdier M. Dietary calcium, vitamin D, and the risk of colorectal cancer in Stockholm, Sweden. Cancer Epidemiol Biomarkers Prev 1996; 5: 897–900.

    PubMed  Google Scholar 

  165. Poulsen HE, Loft S, Vistisen K. Extreme exercise and oxidative DNA modification. J Sports Sci 1996; 14: 343–6.

    Article  PubMed  Google Scholar 

  166. Alessio HM, Goldfarb AH, Cao G. Exercise-induced oxidative stress before and after vitamin C supplementation. Int J Sport Nutr 1997; 7: 1–9.

    PubMed  Google Scholar 

  167. Hellsten Y, Tullson PC, Richter EA, Bangsbo J. Oxidation of urate in human skeletal muscle during exercise. Free Radic Biol Med 1997; 22: 169–74.

    Article  PubMed  Google Scholar 

  168. Kido Y, Tsukahara T, Rokutan K, Shizuka F, Ohnaka M, Kishi K. Japanese dietary protein allowance is sufficient for moderate physical exercise in young men. J Nutr Sci Vitaminol 1997; 43: 59–71.

    PubMed  Google Scholar 

  169. Margaritis I, Tessier F, Richard MJ, Marconnet P. No evidence of oxidative stress after a triathlon race in highly trained competitors. Int J Sports Med 1997; 18: 186–90.

    PubMed  Google Scholar 

  170. Hartmann A, Niess AM, Grunert-Fuchs M, Poch B, Speit G. Vitamin E prevents exercise-induced DNA damage. Mutat Res 1995; 346: 195–202.

    Article  PubMed  Google Scholar 

  171. Cordain L, Latin RW, Behnke JJ. The effects of an aerobic running program on bowel transit time. J Sports Med Phys Fitness 1986; 26: 101–4.

    PubMed  Google Scholar 

  172. Holdstock DJ, Misiewicz JJ, Smith T, Rowlands EN. Propulsion (mass movements) in the human colon and its relationship to meals and somatic activity. Gut 1970; 11: 91–9.

    PubMed  Google Scholar 

  173. Burkitt DP, Walaker AR, Painter NS. Effect of dietary fiber on stools and transit times and its role in the causation of disease. Lancet 1972; 2: 1408–11.

    Article  PubMed  Google Scholar 

  174. Sternfeld B. Cancer and the protective effect of physical activity: the epidemiological evidence. Med Sci Sports Exer 1992; 24: 1195–209.

    PubMed  Google Scholar 

  175. Demers PA, Thomas DB, Rosenblatt KA, et al. Occupational exposure to electromagnetic fields and breast cancer in men [see comments]. Am J Epidemiol 1991; 134: 340–7.

    PubMed  Google Scholar 

  176. Thun MJ, Peto R, Lopez AD, et al. Alcohol consumption and mortality among middle-aged and elderly U.S. adults [see comments]. N Engl J Med 1997; 337: 1705–14.

    Article  PubMed  Google Scholar 

  177. Labayle D, Fischer D, Vielh P, et al. Sulindac causes regression of rectal polyps in familial adenomatous polyps. Gastroenterology 1991; 101: 635–9.

    PubMed  Google Scholar 

  178. Bernstein L, Ross RK, Lobo RA, Hanisch R, Krailo MD, Henderson BE. The effects of moderate physical activity on menstrual cycle patterns in adolescence: implications for breast cancer prevention. Br J Cancer 1987; 55: 681–5.

    PubMed  Google Scholar 

  179. Kelsey JL, Hildreth NG. Breast and Gynecologic Cancer Epidemiology. Boca Raton: CRC Press; 1982.

    Google Scholar 

  180. Henderson B, Ross R, Judd H, Krailo M, Pike M. Do regular ovulatory cycles increase breast cancer risk? Cancer 1985; 56.

  181. Colditz GA, Frazier AL. Models of breast cancer show that risk is set by events of early life: prevention efforts must shift focus. Cancer Epidemiol Biomarkers Prev 1995; 4: 567–71.

    PubMed  Google Scholar 

  182. Frisch R. Delayed menarche and amenorrhea of college athletes in relation to onset of training. JAMA 1981.

  183. Frisch R. Delayed menarche and amenorrhea in ballet dancers. N Engl J Med 1980.

  184. Bullen BA, Skrinar GS, Beitins IZ, vonMering G, Turnbull BA, McArthur JW. Induction of menstrual disorders by strenuous exercise in untrained women. N Engl J Med 1985; 312: 1349–53.

    PubMed  Google Scholar 

  185. Bonen A, Ling WY, MacIntyre KP, Neil R, McGrail JC, Belcastro AN. Effects of exercise on the serum concentrations of FSH, LH, progesterone, and estradiol. Eur J Appl Physiol 1979; 42: 15–23.

    Google Scholar 

  186. Siiteri PK. Adipose tissue as a source of hormones. Am J Clin Nutr 1987; 45: 277–82.

    PubMed  Google Scholar 

  187. Colditz G. Relationship between estrogen levels, use of hormone replacement therapy, and breast cancer. J Natl Cancer Inst 1998; 90: 814–23.

    Article  PubMed  Google Scholar 

  188. Dorgan JF, Longcope C, Stephenson HE, Jr., et al. Relation of prediagnostic serum estrogen and androgen levels to breast cancer risk. Cancer Epidemiol Biomarkers Prev 1996; 5: 533–9.

    PubMed  Google Scholar 

  189. Toniolo PG, Levitz M, Zeleniuch-Jacquotte A, et al. A prospective study of endogenous estrogens and breast cancer in postmenopausal women [see comments]. J Natl Cancer Inst 1995; 87: 190–7.

    PubMed  Google Scholar 

  190. Cauley J, Lucas F, Kuller L, Stone K, Cummings S. Is bone mineral density a biological marker of a woman's cumulative exposure to estrogen? American Epidemiological Society, Rochester, MN; 1997.

    Google Scholar 

  191. Thomas HV, Key TJ, Allen DS, et al. A prospective study of endogenous serum hormone concentrations and breast cancer risk in premenopausal women on the island of Guernsey. Br J Cancer. 1997; 75: 1075–9.

    PubMed  Google Scholar 

  192. Thomas HV, Key TJ, Allen DS, et al. A prospective study of endogenous serum hormone concentrations and breast cancer risk in post-menopausal women on the island of Guernsey. Br J Cancer 1997; 76: 401–5.

    PubMed  Google Scholar 

  193. Berrino F, Muti P, Micheli A, et al. Serum sex hormone levels after menopause and subsequent breast cancer. J Natl Cancer Inst 1996; 88: 291–6.

    PubMed  Google Scholar 

  194. Helzlsouer KJ, Alberg AJ, Bush TL, Longcope C, Gordon GB, Comstock GW. A prospective study of endogenous hormones and breast cancer. Cancer Detec Prev 1994; 18: 79–85.

    PubMed  Google Scholar 

  195. Garland CF, Friedlander NJ, Barrett-Connor E, Khaw KT. Sex hormones and postmenopausal breast cancer: a prospective study in an adult community. Am J Epidemiol 1992; 135: 1220–30.

    PubMed  Google Scholar 

  196. Kuller LH, Gutai JP. Re: ``Sex hormone levels in serum in relation to the development of breast cancer'' [letter]. Am J Epidemiol 1988; 127: 201–2.

    PubMed  Google Scholar 

  197. Wysowski DK, Comstock GW, Helsing KJ, Lau HL. Sex hormone levels in serum in relation to the development of breast cancer. Am J Epidemiol 1987; 125: 791–9.

    PubMed  Google Scholar 

  198. Cauley JA, Lucas FL, Kuller LH, Vogt MT, Browner WS, Cummings SR. Bone mineral density and risk of breast cancer in older women: the study of osteoporotic fractures. Study of Osteoporotic Fractures Research Group [see comments]. JAMA 1996; 276: 1404–8.

    PubMed  Google Scholar 

  199. Gann PH, Hennekens CH, Ma J, Longcope C, Stampfer MJ. Prospective study of sex hormone levels and risk of prostate cancer [see comments]. J Natl Cancer Inst 1996; 88: 1118–26.

    PubMed  Google Scholar 

  200. Cauley JA, Gutai JP, Kuller LH, LeDonne D, Powell JG. The epidemiology of serum sex hormones in postmenopausal women. Am J Epidemiol 1989; 129: 1120–31.

    PubMed  Google Scholar 

  201. Haffner SM, Newcomb PA, Marcus PM, Klein BE, Klein R. Relation of sex hormones and dehydroepiandrosterone sulfate (DHEA-SO4) to cardiovascular risk factors in postmenopausal women. AmJ Epidemiol 1995; 142: 925–34.

    Google Scholar 

  202. Ekin R. The free hormone concept. In: Hennemann G, ed. Thyroid Hormone Metabolism. New York: Marcel Dekker; 1986: 77–106.

    Google Scholar 

  203. Whittemore AS. Personal characteristics relating to risk of invasive epithelial ovarian cancer in older women in the United States. Cancer 1993; 71: 558–65.

    PubMed  Google Scholar 

  204. Pike M, Krailo M, Henderson B, Casagrande J, Hoel D. `Hormonal' risk factors, `breast tissue age' and the age-incidence of breast cancer. Nature 1973; 303: 767–70.

    Google Scholar 

  205. Fleming TR, DeMets DL. Surrogate end points in clinical trials: are we being misled? [see comments]. Ann Int Med 1996; 125: 605–13.

    PubMed  Google Scholar 

  206. Fraser GE, Shavlik D. Risk factors, lifetime risk, and age at onset of breast cancer. Ann Epidemiol 1997; 7: 375–82.

    Article  PubMed  Google Scholar 

  207. Taioli E, Barone J, Wynder EL. A case-control study on breast cancer and body mass. The American Health Foundation—Division of Epidemiology. Eur J Cancer 1995; 31A: 723–8.

    Article  PubMed  Google Scholar 

  208. Rockhill B, Willett WC, Hunter DJ, et al. Physical activity and breast cancer risk in a cohort of young women. NEJM 1998; 90: 1155–60.

    Google Scholar 

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McTiernan, A., Ulrich, C., Slate, S. et al. Physical activity and cancer etiology: associations and mechanisms. Cancer Causes Control 9, 487–509 (1998). https://doi.org/10.1023/A:1008853601471

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